Pretty Penelope Cruz gets an extreme makeover in actor-director Sergio Castellitto's curiously twisted erotic melodrama. Italian doctor Timoteo (Castellitto) is elbow-deep in surgery when he's told his 15-year-old daughter, Angela (Elena Perino), has been critically injured in a motorbike accident. After placing a frantic call to his wife, Elsa (Claudia Gerini), who's on her way to London, Timoteo begins a long, anguished vigil outside the emergency room. Glancing out a nearby window, he notices a woman dragging a chair across the walkway below and seating herself in front of the hospital's entrance. Her back is to the window, but Timoteo instantly recognizes the red shoes, short hair and patchwork shoulder bag, and he's deeply shaken. This unexpected vision sends him careering back to a time before Angela was born when, on a hot and dusty afternoon, his car broke down on a rural road. After a few too many vodkas at a roadside bar, Timoteo returned to the decrepit little house belonging to the beaten-down and tarted-up Italia (the gap-toothed Cruz), who had earlier offered him the use of her phone. Timoteo repaid Italia's kindness by raping her. The good doctor returned to the sleek, chic Elsa, but found himself inexplicably drawn back to bedraggled Italia. The second time he forced himself on her she didn't bother to struggle, even though she wound up with a bloody nose; assuming she's a whore, Timoteo left some lire for her trouble. Not until their third "date" did Italia, who turned out to be a hotel chambermaid, return his embrace and when she offered to make him spaghetti, it was official: They were lovers. Their affair eventually stabilized into something less brutal  Timoteo even invited Italia to join him for a medical conference at a fancy hotel where she couldn't feel more out of place  but the arrangement became untenably complicated when Italia and Elsa simultaneously announced that they were pregnant. It would be easy to write off this unsettling and distasteful romance as a stereotypically chauvinistic fantasy in the Lars Von Trier mode  the kind in which submissive women not only stick by your side, but become your guardian angels  were the novel on which it's based not written by a woman. Cruz's willingness to allow her appearance to be so degraded for cinema's sake doesn't really help, and Castellitto's references to Federico Fellini's put-upon prostitute drama THE NIGHTS OF CABIRIA (1957) only reinforces the unsavory undercurrent of female exploitation.